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Pulmonary clearance

Ying Zhou, Feifei Gao, Chaoyang Chen, Lingyun Ma, Ting Yang, Xiao Liu, Yaou Liu, Xiaoqing Wang, Xia Zhao, Chengli Que, Shuangling Li, JiCheng Lv, Yimin Cui, Li Yang
BACKGROUND: The optimal use of vancomycin in the elderly requires information about the drug's pharmacokinetics and the influence of various factors on the drug's disposition. However, because of sampling restrictions, it is often difficult to perform traditional pharmacokinetic studies in elderly patients. OBJECTIVE: This study was conducted to estimate the population pharmacokinetics of vancomycin in Chinese geriatric patients (age ≥ 65 years) with pulmonary infections and to explore the clinical application of this information for vancomycin dose individualization...
November 30, 2018: European Journal of Drug Metabolism and Pharmacokinetics
Amanda M Healan, Robert A Salata, J McLeod Griffiss, Howard M Proskin, Mary Ann O'Riordan, Wesley A Gray, Jeffrey L Blumer
There is an urgent need to identify safe and effective combination treatments for multidrug-resistant (MDR) Mycobacterium tuberculosis infection (TB). Bedaquiline, a new diarylquinoline, is approved for the treatment of MDR pulmonary TB in combination with other drugs, which could include rifabutin, which is also used to treat drug-resistant TB. Both rifabutin and bedaquiline are metabolized via cytochrome P450 3A4, and rifabutin is an inducer of this enzyme. Bedaquiline is metabolized into its primary N-monodesmethyl metabolite, M2, and further desmethylated into an N-didesmethyl metabolite, M3...
November 30, 2018: Clinical Pharmacology in Drug Development
Vidya Navaratnam, Douglas L Forrester, Kah Peng Eg, Anne B Chang
Bronchiectasis is a chronic lung disease associated with structurally abnormal bronchi, clinically manifested by a persistent wet/productive cough, airway infections and recurrent exacerbations. Early identification and treatment of acute exacerbations is an integral part of monitoring and annual review, in both adults and children, to minimize further damage due to infection and inflammation. Common modalities used to monitor disease progression include clinical signs and symptoms, frequency of exacerbations and/or number of hospital admissions, lung function (forced expiratory volume in 1 s (FEV1 )% predicted), imaging (radiological severity of disease) and sputum microbiology (chronic infection with Pseudomonas aeruginosa)...
November 30, 2018: Respirology: Official Journal of the Asian Pacific Society of Respirology
C Garcia-Alonso, B Gerardin, L Moisson, O Mercier, E Fadel, P Brenot
AIM OF THE STUDY: To establish efficacy and security of invasive treatments for chronic thromboembolic pulmonary hypertension (CTEPH) in elderly patients (≥80 years old): pulmonary endarterectomy (PEA) and balloon pulmonary angioplasty (BPA). PATIENTS AND METHODS: Between 2014 and 2017, 549 CTEPH patients were addressed to our hospital for PEA (364 patients) or BPA (225). From this total, patients 80 years old and over were: 17 treated by PEA and 21 by BPA. Demographic characteristics as well as hemodynamic parameters, results and complications were compared for both groups (Young - Y - versus Old - O)...
December 2018: Annales de Cardiologie et D'angéiologie
Xiaoliang Liang, Kushagra Gupta, Joselyn Rojas Quintero, Manuela Cernadas, Lester Kobzik, Helen Christou, Gerald B Pier, Caroline A Owen, Sule Çataltepe
Fatty acid binding protein 4 (FABP4), an intracellular lipid chaperone and adipokine, is expressed by lung macrophages, but the function of macrophage-FABP4 remains elusive. We investigated the role of FABP4 in host defense in a murine model of Pseudomonas aeruginosa pneumonia. Compared with wild-type (WT) mice, FABP4-deficient (FABP4-/- ) mice exhibited decreased bacterial clearance and increased mortality when challenged intranasally with P. aeruginosa. These findings in FABP4-/- mice were associated with a delayed neutrophil recruitment into the lungs and were followed by greater acute lung injury and inflammation...
November 21, 2018: FASEB Journal: Official Publication of the Federation of American Societies for Experimental Biology
Jun Ren, Yingmei Zhang
Aging, an irreversible biological process, serves as an independent risk factor for chronic disease including cancer, pulmonary, neurodegenerative, and cardiovascular diseases. In particular, high morbidity and mortality have been associated with cardiovascular aging, but effective clinical therapeutic remedies are suboptimal for the ever-rising aging population. Recent evidence suggests a unique role for aberrant aggregate clearance and the protein quality control machinery - the process of autophagy - in shortened lifespan, compromised healthspan, and the onset and development of aging-associated cardiovascular diseases...
December 2018: Trends in Pharmacological Sciences
Stacey K Dull, Brooke D Havlat, Michael J Sanley, Mark A Malesker
OBJECTIVE: The purpose of this report is to describe the case of a 43-year-old male with asthma who was hospitalized for an exacerbation of non-cystic fibrosis bronchiectasis (NCFB), a chronic lung disease that is characterized by dilation of the airways, persistent cough, chronic sputum production, and recurrent respiratory infections. He was treated with oral and inhaled antibiotics, inhaled bronchodilators, and aggressive airway-clearance techniques including nebulized 7% sodium chloride, flutter valve, and high-frequency chest wall oscillation...
November 1, 2018: Consultant Pharmacist: the Journal of the American Society of Consultant Pharmacists
Yussr M Ibrahim, Nicole R Marques, Carlos R Garcia, Michael Salter, Christopher McQuitty, Michael Kinsky, Mindy Juan, Achiau Ludomirsky
Background: Intravascular air embolism (AE) is a preventable but potentially catastrophic complication caused by intravenous tubing, trauma, and diagnostic and surgical procedures. The potentially fatal risks of arterial AE are well-known, and emerging evidence demonstrates impact of venous AEs on inflammatory response and coagulation factors. A novel FDA-approved in-line air detection and purging system was used to detect and remove air caused by administering a rapid fluid bolus during surgery...
2018: Perioperative Medicine
Teclegiorgis Gebremariam, Sondus Alkhazraji, Abdullah Alqarihi, Heewon H Jeon, Yiyou Gu, Mili Kapoor, Karen J Shaw, Ashraf S Ibrahim
Invasive pulmonary aspergillosis (IPA) due to Aspergillus fumigatus is a serious fungal infection in the immunosuppressed patient population. Despite the introduction of new antifungal agents, mortality rates remain high and new treatments are needed. The novel antifungal APX001A targets the conserved Gwt1 enzyme required for the localization of glycosylphosphatidyl inositol (GPI)-anchored mannoproteins in fungi. We evaluated the in vitro activity of APX001A against A. fumigatus and the in vivo activity of its prodrug APX001 in an immunosuppressed mouse model of IPA...
November 19, 2018: Antimicrobial Agents and Chemotherapy
Ethan Singer, Judi E Miller
We read with interest the recent case reports in this journal on the apparent beneficial effects of long-term, high-dose guaifenesin in patients with chronic respiratory disease. This prompted us to review our own patient database as we also recommend daily guaifenesin to patients who report problems with mucociliary clearance. In our rural primary care practice, we currently have over 20 patients who have taken guaifenesin daily, for more than 3 years as an adjuvant to their prescribed medications for either chronic obstructive pulmonary disease (COPD) and/or stable chronic bronchitis...
2019: Respiratory Medicine Case Reports
Shulei Zhang, Guibin Pang, Chao Chen, Jianzhong Qin, Huan Yu, Yongming Liu, Xihui Zhang, Zhentao Song, Jian Zhao, Fujun Wang, Yangyun Wang, Leshuai W Zhang
Polysaccharides purified from natural herbs possess immunoregulatory functions, while the efficacy of natural polysaccharides on cancer treatment remains unreliable, likely due to their low prescribed doses and fast clearances in clinical settings. In this study, gold nanocomposites containing Ganoderma lucidum polysaccharide (GLP-Au) efficiently induced dendritic cell (DC) activation, evident by the increase of CD80/CD86/CD40/MHCII, decrease of phagocytic ability and acid phosphatase activity, and increased cytokine transcription...
February 1, 2019: Carbohydrate Polymers
David J Thornton, Catherine Sharpe, Caroline Ridley
Mucociliary clearance is a crucial component of innate defense of the lung. In respiratory diseases, such as asthma, chronic obstructive pulmonary disease, and cystic fibrosis, mucus with abnormal properties contributes to obstruction of the airways. The failure in function of mucus in airway clearance and pathogen protection leads to chronic infection and risk of death. Polymeric mucins (MUC5AC and MUC5B) provide the structural framework of the airway mucus gel. The intracellular synthesis and assembly of these enormous, polymeric O-linked glycoproteins is a complex, multistage process involving intra- and intermolecular disulfide bond formation and extensive addition of O-glycan chains...
November 2018: Annals of the American Thoracic Society
Jeffrey A Whitsett
The lung is continuously exposed to particles, toxicants, and microbial pathogens that are cleared by a complex mechanical, innate, and acquired immune system. Mucociliary clearance, mediated by the actions of diverse conducting airway and submucosal gland epithelial cells, plays a critical role in a multilayered defense system by secreting fluids, electrolytes, antimicrobial and antiinflammatory proteins, and mucus onto airway surfaces. The mucociliary escalator removes particles and pathogens by the mechanical actions of cilia and cough...
November 2018: Annals of the American Thoracic Society
Andrea Hahn, Caroline Jensen, Hani Fanous, Hollis Chaney, Iman Sami, Geovanny F Perez, Stan Louie, Anastassios C Koumbourlis, James E Bost, John N van den Anker
OBJECTIVES: To determine the frequency of subtherapeutic exposure to intravenously administered β-lactam antibiotics in a cohort of cystic fibrosis (CF) patients who were treated for a pulmonary exacerbation, and its impact on pulmonary function. METHODS: Nineteen CF patients between the ages of 5 and 21 years treated at Children's National Health System for a pulmonary exacerbation were followed between March 2015 and August 2016 in a prospective, longitudinal study...
September 2018: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
F F Liu, J N Gong, Y Jiang, T G Kuang, Y H Yang
Objective: To investigate the diagnostic value of N-terminal pro-brain natriuretic peptide (NT-proBNP) and troponin Ⅰ (TnI) for detecting right ventricular dysfunction (RVD) in patients with non-high-risk acute pulmonary thromboembolism (APE). Methods: A retrospective analysis was performed in 96 adult patients [44 males, 52 females, aged (61±14) years] with non-high-risk APE from January 2015 to June 2016. All patients were divided into RVD group and non-RVD group according to whether there was right ventricular enlargement on echocardiography...
November 12, 2018: Chinese Journal of Tuberculosis and Respiratory Diseases
Mirjam Stahl, Mark O Wielpütz, Isabell Ricklefs, Christian Dopfer, Sandra Barth, Anne Schlegtendal, Simon Y Graeber, Olaf Sommerburg, Gesa Diekmann, Johannes Hüsing, Cordula Koerner-Rettberg, Lutz Nährlich, Anna-Maria Dittrich, Matthias V Kopp, Marcus A Mall
RATIONALE: Cystic fibrosis (CF) lung disease starts in early infancy suggesting that preventive treatment may be most beneficial. Lung clearance index (LCI) and chest magnetic resonance imaging (MRI) have emerged as promising endpoints of early CF lung disease, however, randomized controlled trials testing the safety and efficacy of preventive therapies in infants with CF are lacking. OBJECTIVES: To determine feasibility, safety and efficacy of preventive inhalation with hypertonic saline (HS) compared to isotonic saline (IS) in infants with CF including LCI and MRI as outcome measures...
November 9, 2018: American Journal of Respiratory and Critical Care Medicine
Marwan Sheikh-Taha, Mary E Deeb
BACKGROUND: Non-vitamin K oral anticoagulants (NOACs) have emerged as an attractive alternative to vitamin K antagonists for various thromboembolic indications. However, prescribed NOAC doses are often inconsistent with drug labeling and prescribers might not consider the potential risks associated with concomitant use of other drugs, which can compromise NOACs' safety and effectiveness. METHODS: A retrospective chart review was conducted in a tertiary care center in USA over a 4-month period...
November 8, 2018: American Journal of Cardiovascular Drugs: Drugs, Devices, and Other Interventions
Virginia Santiago, Katayoun Rezvani, Takuya Sekine, Justin Stebbing, Peter Kelleher, Darius Armstrong-James
Pulmonary aspergillosis is an opportunistic fungal infection affecting immunocompromised individuals. Increasing understanding of natural killer (NK) cell immunobiology has aroused considerable interest around the role of NK cells in pulmonary aspergillosis in the immunocompromised host. Murine studies indicate that NK cells play a critical role in pulmonary clearance of A. fumigatus . We show that the in vitro interaction between NK cells and A. fumigatus induces partial activation of NK cell immune response, characterised by low-level production of IFN-γ, TNF-α, MIP-1α, MIP-1β, and RANTES, polarisation of lytic granules and release of fungal DNA...
2018: Frontiers in Immunology
Jiehua Deng, Gangsheng Wang, Jihong Li, Yile Zhao, Xiaolu Wang
Background: The invasive pulmonary aspergillosis is a kind of high incidence of disease with difficulties in treatment, poor prognosis, and high mortality. Objectives: The study aimed to reveal the effect of cinnamaldehyde on the fungal cell wall and verify its efficacy on invasive pulmonary aspergillosis on immunosuppressed Institute of Cancer Research mice (ICR mice). Methods: ICR mice were given cyclophosphamide 200 . d-1 by intraperitoneal injection for 2 days...
2018: Evidence-based Complementary and Alternative Medicine: ECAM
Jef Serré, Carolien Mathyssen, Tom Tanjeko Ajime, Hannelie Korf, Karen Maes, Nele Heulens, Conny Gysemans, Chantal Mathieu, Bart Vanaudenaerde, Wim Janssens, Ghislaine Gayan-Ramirez
Chronic obstructive pulmonary disease (COPD), which is characterized by an excessive inflammatory response of the airways, is often complicated by exacerbations. Vitamin D deficiency has been associated with an increased risk for COPD and may predispose COPD patients to a higher exacerbation rate, particularly during smoking. In the current study, we investigated the effect of vitamin D deficiency and cigarette smoke (CS)-exposure on lung inflammation and bacterial clearance after an acute infection with Nontypeable Haemophilus influenzae (NTHi)...
November 3, 2018: Journal of Steroid Biochemistry and Molecular Biology
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